Prostate specific antigen measurements after minimally invasive surgery ofthe prostate in men with benign prostatic hypertrophy

There is a trend of minimally invasive surgery in the treatment of benign p rostatic hypertrophy (BPH). Studies have examined levels of prostate specif ic antigen (PSA) in patients after open prostatectomy or transurethral rese ction of prostate (TURP) and noted reset of PSA to lower values after surge ry. We reviewed PSA levels in patients after minimally invasive procedures to determine if levels were reset. There were 120 patients (age 45-70) enrolled in the study. Fifty patients u nderwent laser ablation, 20 patients had electrovaporization (TVP) and 50 p atients underwent TURF. PSA measurements were obtained prior to and after s urgical procedures in a three-year follow-up. Mean pre-operative PSA was 2.8 (+/- 0.34) ng/ml for laser cohort, 3.2 (+/- 0.31) ng/ml for the TURF group and 2.3 (+/- 0.42) ng/ml for TVP patients (P = 0.33). At 1 y follow-up, mean PSA decreased 32% for laser patients, 46% for the TURF cohort and 8% for TVP group. The largest mean decrease in PSA velocity was - 1.5 (+/- 0.31) ng/ml per y for TUFF followed by 0.9 (+/- 0.2 9) ng/ml per y for laser patients and - 0.1 (s.d. +/- 1.2) ng/ml per y for TVP group in y 1. The TURF group maintained the largest decrease in PSA vel ocity in y 5 - 0.6 (+/- 0.26) ng/ml per y. Three patients (2-TURP, 1-TVP) w ere diagnosed with prostate cancer during follow-up. In conclusion, serum PSA levels were reset at lower levels following differ ent surgical interventions. This lower level of PSA remained decreased for 2 y postprocedure. Urologists should be cognizant of this reset level and m onitor PSA levels for possible increases to screen for prostate cancer in t his patient population.